High inhaler costs increase difficulties for patients, cause skipped doses

Key takeaways:

• An increase in perceived difficulty was found when medications cost more than $50.
• Patients with private insurance reported the most difficulty.
• Patients with Medicare were split 50-50 on cost difficulty.

SAN DIEGO — More research is needed to determine drivers of inhaler costs and patient knowledge on available financial assistance, according to a poster presentation here.

The results of this quality improvement study were presented at the 2025 American Academy of Allergy, Asthma and Immunology/World Allergy Organization Joint Congress.

“We were really looking at the impact of inhaler costs on patient access and usage,” Tahj Morales, BS, medical student at Penn State College of Medicine, told Healio.

Morales and colleagues surveyed patients about inhaled medication costs and whether these costs were considered affordable.

“We all know that cost is a huge factor in patients being able to afford medications, but there’s not a ton of data on what cost is the problem,” Morales said. “The goal of this is getting numbers to show and data to show it in the literature.”

In total, 43 patients were sampled from an asthma, allergy and immunology clinic in Hershey, Pennsylvania. The study analyzed perceived difficulty of affording inhaled asthma medications as either difficult or not difficult.

“We also analyzed factors like whether or not they skipped doses and what type of insurance they had, which we ranked as private, Medicare or Medicaid,” Morales said.

The research team also looked at race as a factor as well as cost thresholds.

Results showed that patients who paid more than $50 for medications had an associated increased perceived difficulty affording asthma medications.

“You can see that when medications are under $50, 100% of the respondents rated that it was not difficult, but the second you jump to greater than $50, you had 80% of respondents saying it was difficult,” Morales said.

Increased inhaler costs were also associated with patients skipping doses, according to study results.

“Of those that reported skipping a dose, 96% of them paid $50 or more for their medications every month,” Morales said.

Among patients who did not skip a dose, only 37% paid $50 or more for their medications each month.

When looking at insurance type, patients with private insurance reported the highest levels of perceived difficulty in affording their medications.

“Right now, we see that about 75% of those with private insurance rated that as difficult for affording their medications,” Morales said. “Overall, we’re really just seeing this huge increase in perceived difficulty.”

Also, 50% of patients on Medicare and 53.8% of patients on Medicaid said that their monthly medications were difficult to afford.

Morales emphasized the need to better understand high-cost drivers and their causes as well as the gaps in patient knowledge of financial assistance. In terms of future studies, Morales said he is looking to better characterize the association of cost and asthma outcome, in addition to expanding the patient population in terms of demographics and getting a greater number of survey respondents.

“Everyone is in agreeance that cost is a huge factor,” he said. “It’s really just helping patients as much as possible to understand the financial resources available to them, having those conversations with patients, if they do report any difficulty with their medications, about what is the driver of that difficulty, and what we may be able to do as physicians to help them out or give them more resources to help them figure out what they can do.”